What are the costs of Obesity?

By Dianne Piaskoski
Twenty-four percent of the adult population in Ontario is obese and another 12% is overweight (See The Toronto Star, June 20, 2011). That’s a total of 3.15 million obese or overweight adults in Ontario and these numbers are on the rise.

Obesity puts people at extremely high risk for heart disease and stroke. Other ailments such as diabetes, destroyed knees, blood clots, organ diseases, infertility, sleep apnea, and cancer are also more prevalent with increasing weight gain. The cost to the Ontario health care system? At least $1.1 billion annually. The province loses another $1.5 billion annually in productivity.

Ontario has tried to solve this impending financial crisis by offering a $75 million program to provide bariatric bypass surgery at a cost of $18,000 for each procedure. Nine million of the $75 million has been spent on increasing the number of bariatric centres in Ontario and in equipping hospital rooms with toilets that can bear up to 1000 pounds.

Sixteen hundred Ontario adults have already had the provincially funded operation with eight thousand more being referred for an assessment. This has only included the morbidly obese and the wait is one year for their initial appointment.

Is this a cost efficient solution?

An Ontario man paid to have bariatric lap band surgery, a procedure where an inflatable ring is placed around the upper part of the stomach to reduce intake. He lost 100 pounds in the first nine months. Yet, the lap band did nothing to change his emotional drive to eat. He subsequently regained the weight. He bemoaned the fact that there were no weekend support groups and no counsellors available in the evenings when he was most prone to overeating — hardly a cost effective solution.

This man’s experience highlights that surgical “solutions” fall short. Surgery does not address the underlying causes of overeating which lead to obesity. Excessive eating can be a means of overriding emotional distress. Overeating can be a major symptom of food addiction — using food as the substance that fills an emotional void.

The Ontario Ministry of Health Promotion and Sport is responsible for preventing obesity. At surgeries costing $18,000 per patient and sustained success not guaranteed, perhaps it would be more effective to put its resources into the science and nature of food addiction. For now, the lap band solution may literally be, a “band” aid solution.

There are some ventures to address the underlying dynamic: Dr. Jill Hamilton, director of STOMP (SickKids Team Obesity Management Program) says; “Most programs are just about teaching people what to eat, what to limit. They don’t often deal with the underlying reasons for why it’s hard (to lose and keep the weight off).” STOMP ‘s focus is to connect obese youth to peers who have gone through the exact same situation.